1. Field of the Invention
The present invention concerns an access controller for controlling access to medical data as well as for controlling access to medical data.
2. Description of the Prior Art
In the field of medical technology, frequently a first doctor examines a patient and generates a finding based on the examinations, followed by a treatment of the patient by a second doctor using the finding made by the first doctor. The first doctor typically bases the generation of the finding on diverse measurement results of the patient such as, for example, x-ray images or CT images.
For the first assessing doctor, it is frequently necessary to review a number of measurement results of the patient to produce a finding, but often only a small subset of the available measurement results of the patient are relevant for the actual finding.
The finding generated in this manner typically is written in a patient file by the first doctor for reproduction at the treating second doctor. The measurement results (for example the x-ray images of the patient) normally remain with the assessing doctor, and only the patient file with the finding is forwarded to the doctor conducting the further treatment.
In modern hospitals it is known to store the patient file of the patient in digital form in a first file and to store the measurement results (such as subtraction angiography x-ray images of the patient) in a second file independent of the first file, in order to increase the availability of both the patient file and the measurement results.
In general, the findings of the patient that are stored in the first file are stored wholly independent of the measurement results of the patient that are stored in the second file.
The digital patient files with the findings are frequently stored in an RIS databank and the measurement results used to generate the findings are frequently stored in a PACS databank. Although the RIS databank can be integrated into the PACS databank, a linking of the entries in the RIS databank to entries in the PACS databank conventionally occurs only in a limited manner. In known systems it is thus possible to open the measurement results in the PACS databank that are associated with the patient entry by double-clicking on a patient entry in the RIS databank. A link between the RIS and the PACS databank, however, exists only across the same patient entries and not with regard to individual findings.
Various requirements are placed on the generation of a finding in a medical patient file. The perception and experience of the finding doctor should enter into the finding. Normally the findings are therefore structured in two parts. The state of the patient established from the measurement results is discussed briefly in a first part and a short conclusion is drawn from this in a second part.
The classical finding written in a patient file thus corresponds to the inductive procedure in which facts are weighed and a conclusion is drawn therefrom.
The previously described conventional design of a finding has various disadvantages. It is necessary for the doctor performing further treatment to read the entire finding until that doctor comes to the end of the result. This is particularly disadvantageous given the use of digital patient files since the doctor performing further treatment in this case must frequently page or scroll through various pages.
A different design of findings is therefore to be chosen given the use of digital patient files:
The most important assessments and conclusions should initially be sorted according to their importance. A comparison with the measured measurement results should subsequently be possible. This comparison is very important in order to preclude malpractice, since without such a comparison it is not possible for a doctor performing further treatment to be able to establish incorrect findings of the assessing doctor. Furthermore, via such a comparison it is possible to render the finding more concretely and to make it more comprehensible at a later point in time. The omission of a comparison of the finding with the measured measurement results can make a doctor performing further treatment liable for damages.
In order to enable such a comparison in findings written down in digital patient files, it is known for the finding doctor to manually characterize the measurement results used for the finding with an identification character. This identification character is stored in the second file as a data attribute together with the measurement result and allows the second file to be searched for according to the identification character.
This procedure has the disadvantage that a doctor performing further treatment must not only study the patient file of the patient that is written in the first file in order to arrive at knowledge of a finding, but also must set up a filter function using this finding for searching through the second file which contains the measurement results.
Such a filter function typically includes a patient identification as well as the identification character.
It should be emphasized that no indication of the identification character associated with the measurement result stored in the second file is contained in the finding stored in the first file. Rather, in the search for measurement results forming the basis of a finding, the doctor performing further treatment must search for the filter function using a library of suitable identification characters. As a result, the addition of identification characters to the measurement results stored in the second file does not result in an effective relation to the findings stored in the first file.
It is thus always necessary to search through the entire second file for measurement results with the identification character, which causes an increased network traffic and an increased computer capacity requirement. Furthermore, errors frequently occur in the arrangement of the filter function that lead to the situation of measurement results that play no role whatsoever for the respective finding being provided to the doctor performing further treatment. The acceptance of the previously known systems is low as a consequence of this.
A further disadvantage of the marking of the measurement results with identification characters is that a file attribute must be added to the measurement results. This requires a clean definition of the identification characters in order to enable a later filtering with high reliability, and is therefore very inflexible.